Aircraft Information:
Average Load Factors: Aircraft #1: Aircraft #2: Aircraft #3: Aircraft #4: Aircraft #5:
Date Insurance is to begin: Signature of Applicant: Title:
Pilot Qualifications (List All Pilots Who Will Operate the Aircraft):
Does Applicant/Owner participate in formal flight training program for each insured aircraft? Choose One: Yes No Name of School: Date last completed by each pilot: Does school have visual flight simulator for each make and model? Choose One: Yes No
Has each pilot completed manufacturer's ground school for the make and model of aircraft?
Will anyone other than the pilots named above operate the Applicant's aircraft? Choose One: Yes No If Yes, Explain: Does Applicant/Owner employ their own maintenance people? Choose One: Yes No Have the maintenance personnel completed manufacturer's maintenance course? Choose One: Yes No
Loss History:
Chief Pilot is: Director of Flight Operations is:
Signature of Chief Pilot or Director of Flight Operations: